idea of having dedicated orthopedic on-call doctors, or "doods" for
short. Nine orthopods agreed to dood duty on a rotating basis. They're
scheduled 6 months in advance and evenly distributed. The key was
incentivizing docs to miss a day in the OR.
"The buy-in from the surgeons came when we started to pay on-call
pay," says Ms. Singleton, orthopedic business director at Cincinnati
Children's. "Because when they're doods, they have to cancel their
other consultations. Our physicians are paid based on productivity, so
if they're having to cancel elective surgeries to be in the clinic, it
means they're not necessarily earning anything."
This way, when dood time comes around, at least they're guaranteed
something, she says.
The arrangement lets patients who come in with a fracture or other
injury see a physician right away. Severe cases can be admitted on the
spot. With less severe cases requiring surgery, the procedure is sched-
uled for the next morning and the patient is temporarily discharged.
"When we can, we let them go home," says Carie Norris, RN, MSN,
clinical manager for ambulatory orthopedics and sports medicine at
Cincinnati Children's. "That way we save the time, we save the charge
and we save the anxiety of a hospital stay for the family."
Flexible flow
At the highly specialized Orthopedic Surgery Center of San Antonio,
it's not uncommon for trauma patients to be treated almost immedi-
ately.
"Are we able to get patients into the clinic and bring them into the
OR the same day? The answer is yes," says Ron Bullock, director of
clinical and ambulatory services for the San Antonio Orthopedic
Group and the surgery center.
A recent example? "One of our hand doctors got a call from a refer-
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